Date of Award

Spring 2023

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

McHugo, Jeanie

Second Advisor

Kauffman, Russell

Keywords

Rotator cuff pathology, physical therapy, conservative treatment for rotator cuff pathologies, combination of steroids and therapy, steroid injections, functional range of motion of the shoulder, shoulder pain, weakness in shoulder, dysfunctional shoulder

Abstract

Rotator cuff pathologies seen in a primary care setting ranks third for musculoskeletal complaints seen by primary care providers. Rotator cuff pathologies can cause significant dysfunction in activities of daily living (ADLs), work tasks, and daily life. Current treatment recommendations are intra-articular steroid injections, therapy only rehabilitation, or the combination of the two. This literature review researched articles comparing the effectiveness of steroid only treatments, therapy only treatments, and the combination of the two. There was conflicting evidence regarding which treatment was the most effective. Significant side effects for steroid injections were discovered which included rotator cuff rupture. Therapy demonstrated improvements with range of motion and decreasing pain. There were studies demonstrating the positive effects of combination of the two when compared to steroid injection and therapy only groups individually. There was one study that showed no difference between all three interventions. Given this information further research is indicated before a definitive answer can be concluded on which treatment approach is superior for rotator cuff pathologies. The author recommends that if a patient is a possible surgical candidate to omit the steroid injection and attempt physical therapy with orthopedic referral. If the patient is not a possible surgical candidate, then the combination of steroid injection and physical therapy should be recommended.

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